The present invention generally relates to training models, and more specifically, but not exclusively, concerns an interactive breast examination training model that is able to dynamically change the location, size, and hardness of simulated tumors.
Breast cancer kills approximately 40,000 women yearly in the United States and about 200,000 new cases were diagnosed in 2001. Early detection of breast cancer leads to better and less disfiguring outcomes. For example, data collected over the last several years indicates that if tumors are caught at 2.0 cm, the five-year survival rate exceeds 98%. Methods of detection include mammography, breast self-examination (BSE), and clinical breast examination (CBE). Mammography is an effective tool with limitations of lower sensitivity in younger patients, a high false alarm rate, and low correlation with a decreased mortality rate. BSE is a low-cost detection tool, effective for frequent change monitoring, but not recommended alone. CBE is a practical, low-expense, and highly effective method with proper physician education. CBE is a manual clinical inspection employed for early detection and assessment of breast cancers. Utilizing CBE palpation, physicians search for breast tumors of variable hardness, size, depth, and mobility. Successful tumor localization should be the result of thorough training in tumor characteristic identification and tactile palpation. However, like the sense of touch in general, tumor palpation is not well understood. The tactile sense is often under-trained, leading to low confidence in and under-utilization of CBE. Current training techniques often either prepare a trainee for tumor detection using a static silicone training device or train for high sensitivity without considering specificity. If a physician cannot transfer his training to real breast tissue or differentiate between tumorous and non-tumorous glandular tissue, results will not be acceptably accurate, reproducible, or clinically useful. Currently, detection skills are low among physicians because of a lack of clinical skill training. CBE tumor detection effectiveness can improve through tactile training associated with good teaching. Moreover, evidence suggests that well trained physicians performing CBE could make mammography unnecessary.
There is no standardized CBE practice or training style. Most CBE literature points to the importance of search technique, including use of search pattern, number of fingers, pressures, and finger motions. While search technique can improve overall detection rates, it is possible that consistent, reliable, and verifiable improvement comes from tactile discrimination development. Palpation practice on silicone breast models has been proven to increase the skill level of tumor detection in breast tissue. MAMMACARE brand silicone breast models (Mammatech Corporation, Gainesville, Fla.) attempt to improve tactile skills, with highly recognized models containing static tumors positioned at specified locations. While sensitivity increases in almost all studies involving MAMMACARE brand models, specificity typically decreases, as seen in high numbers of false-positive reports. Also, while the silicone consistency varies, all models contain the same number of tumors in the preset locations. Once tumors are found, the model yields little further training, feedback, or proficiency gains.
Thus, there remains a need for an improved system for simulating breast tumors for CBE training.